Health Care Access and Perceptions of Provider Care among Individuals in Same-Sex Couples
Slide presentation from the AHRQ 2011 conference.
On September 19, 2011, James Kirby made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (100 KB). Plugin Software Help.
Slide 1
Health Care Access and Perceptions of Provider Care among Individuals in Same-Sex Couples
Joseph Clift
AHRQ/Environmental Protection Agency
James Kirby
AHRQ
Slide 2
Background
- Most research on gay, lesbian, bisexual and transgender (LGBT) people focuses on health disparities, not access, use or perceptions.
- Most research is based on small, convenience samples.
Slide 3
Objective
- Compare individuals in same-sex couples to those in different-sex married couples:
- Access.
- Preventive Use.
- Perceptions of care.
Slide 4
Method
- Descriptive statistics with difference tests corrected for the complex sample design.
- Logistic regression models controlling for a limited number of basic sociodemographic variables:
- Age, household income, highest degree, metropolitan residence and insurance status.
Slide 5
Data
- Medical Expenditure Panel Survey, pooled for 1996-2007.
- Sample: individuals who are married or who report having a "partner" of the same sex:
- 136,676 married individuals.
- 696 individuals in same sex couples.
Slide 6
Variables
- Access.
- Preventive Use.
- Perceptions of Provider Care.
Slide 7
Results: Access
Image: Bar graph shows the following data:
| Different-sex married | Same-sex | |
|---|---|---|
| Has USC | 83% | 81% |
| Got appt when wanted (urgent) | 85% | 79% |
| Got appt when wanted (non-urgent) | 84% | 74% |
| Easy to see a specialist | 77% | 62% |
Slide 8
Results: Access
Image: Bar graph shows the following data:
| Different-sex married | Same-sex | |
|---|---|---|
| Unable to get dental care | 3% | 4% |
| Delayed in getting dental care | 3% | 5% |
| Unable to get Rx | 2% | 2% |
| Delays in getting Rx | 3% | 6% |
Slide 9
Results: Preventive Use
Image: Bar graph shows the following data:
| Different-sex married | Same-sex | |
|---|---|---|
| Had routine checkup | 65% | 64% |
| Had flu shot | 32% | 39% |
| Had blood pressure checked | 84% | 83% |
Slide 10
Results: Perceptions of Provider Care
Image: Bar graph shows the following data:
| Different-sex married | Same-sex | |
|---|---|---|
| Clear explanations provided | 93% | 90% |
| Provider showed respect | 93% | 88% |
| Unable to get Rx | 2% | 2% |
| Provider spent enough time | 87% | 80% |
Slide 11
Odds-ratios from Logistic Regression Model
| Variable | Different-sex | Same-sex |
|---|---|---|
| Got medical appointment when wanted (urgent) | 1.0 | 0.8 |
| Got medical appointment when wanted (non-urgent) | 1.0 | 0.6 |
| Easy to see a specialist | 1.0 | 0.6 |
| Delayed in getting necessary prescription drugs | 1.0 | 2.4 |
| Had flu shot in last year | 1.0 | 1.7 |
| Doctor showed respect | 1.0 | 0.6 |
| Doctor spent enough time | 1.0 | 0.7 |
Slide 12
Summary and Conclusions
- Statistically significant differences exist on:
- Timeliness of getting appointments and Rx drugs.
- Ease in seeing specialists.
- Annual flu shot.
- Most measures show no statistically significant difference.
- Overall pattern of differences indicate that individuals in same-sex couples have generally worse access and more negative perceptions of care:
- Annual flu shot is the exception.
Slide 13
Limitations
- Cannot infer to LGBT people, only to those in same-sex cohabiting couples.
- Differences are "averages" over 12 years.
- Descriptive.
